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Hospice is based upon the philosophy that death is a natural process and that comfort/alleviating symptoms/pain and increasing the quality of living is the most important service you can provide for a terminal loved one or friend. The primary goal of hospice is not to help the patient die, but to encourage t patients to live as fully as possible each day that they are alive. Be aware that if the patient survives six months during hospice, and it is determined by a physician that they won’t survive another six months, they are allowed to stay in the hospice program.

Services are defined by Medicare Hospice Benefit whether they are covered by Medicare, Medicaid, or private insurance. For Medicare to cover hospice, a physican must certify that a patient has six months or less to live.

Service can include:

Nursing services

Physician participation (hospice medical director in addition to the patient’s personal physician)

Medical; social services (social worker to help with emotional and social needs);

Spiritual care

Counseling services, and bereavement for the family

Home health aide services (personal care usually 2-3 times a week)


Medical equipment (may include hospital bed, wheelchair, oxygen, etc)

Necessary lab tests

Physical, occupational and speech therapy.

Hospice volunteers make up a large part of the patient support and will come to read, give a massage, play music or just sit and talk with the patient.

What is Meant by “people regularly graduate from Hospice?”


Approximately two-thirds of hospice patients die (graduate) within 30 days (National Center for Health Statistics at CDC).  The balance either stay in hospice another six months or leave hospice care.

There are several reasons why patients survive hospice. The McClatchy/Pioneer Press latest report states that hospice patients are no longer predominately cancer patients; but now include people with heart, lung, kidney and liver problems where physical decline is less predictable. Also patients’ health may improve because they are receiving better care via hospice than they were without it.

Why do Families Often say they Wish they had Hospice Sooner?    

It is common to hear “If I had known she/he was going to die we would have had hospice sooner” or “If we had known how wonderful hospice was, we would have taken advantage of this support earlier.”
A good hospice can make the last months of a loved one’s life longer, less stressful, less lonely and more comfortable. However, we as a nation have medicalized the dying process; thus death is often seen as a failure of the system and hospice a sign that we have given up vs. accepting what is to come.

For-Profit vs. Non-Profit Hospices

The funds coming in from Medicare are the same whether the hospice is non-profit or for-profit. For-profits are based on the business model and owners/directors expect to make a profit. With the baby-boom generation coming into retirement, there has been a huge increase in for-profit hospices coming into the market.

A  study by Medical Care of 422 hospices found that for-profit hospitals received the typical full-range of hospice care only half the time - compared to patients in non-profit hospices. A follow-up study confirmed these results. The future will be interesting to follow as Medicare regulations never anticipated the hospice concept to could be for-profit organizations.

The truth is there are some very good for-profit and some very good non-profit hospices. The best way to confirm hospice care in your demographic area is to 1) ask for references and contact those families about their experience with a particular hospice and 2) research consumer reviews of a hospice online.

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Often it is difficult if not impossible to keep everyone aware of what is happening. CaringBridge provides the opportunity to do so and also allows friends and family to communicate back, through a guestbook, their thoughts and support.

For more information and to create such a Website at no cost go to

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